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MON-PP206: Artificial Nutrition: Clinical Experience and Trend in a Southern Italy University Hospital
S204 MON-PP204 WARDS WITH GOOD NUTRITIONAL PRACTICE ARE ASSOCIATED WITH BETTER INTEGRATION OF CLINICAL DIETITANS: A QUESTIONNAIRE BASED SURVEY AMONG DOCTORS AND NURSES IN NORWAY S.H. Fjeldstad1 , M. Mow´ e2 , Ø. Irtun3 . 1 University Hospital of Northern Norway, Tromsø, 2 Oslo University Hospital, Oslo, 3 Department of gastrointestinal surgery, University Hospital of Northern Norway, Tromsø, Norway Rationale: There are many barriers to good nutritional practice in hospitals; lack of knowledge among doctors and nurses are one of them. A multidisciplinary approach is recommended for good quality nutritional care and the aim of this study was to assess if there were any differences in integration of clinical dietitians between wards with good and insufficient nutritional practice. Methods: A questionnaire was mailed to 4000 doctors and nurses. The overall response rate was 22%. The questionnaire contained eleven statements about nutritional routines. The respondents ranked the statements based upon the existing routines in their own ward. Then, all respondents were given a total score and categorized dependent on the quality of the nutritional routines in their ward; (1) wards with good nutritional practice and (2) wards with insufficient nutritional practice. Results: Doctors and nurses working in wards with good nutritional practice reported better knowledge of clinical dietitians, had better access to clinical dietitians and consulted clinical dietitians more often compared to doctors and nurses in wards with insufficient nutritional practice. Clinical dietitians also took part in multidisciplinary meetings more often in wards with good nutritional practice. In addition, the “National guidelines of prevention and treatment of malnutrition” was more known among doctors and nurses working in wards with good nutritional practice, and they also reported that these guidelines had been important during the implementation of their own routines. Conclusion: The present study shows that wards with good nutritional practice are associated with a better integration of clinical dietitians compared to wards with insufficient practice. Disclosure of Interest: None declared
MON-PP205 HIGH PREVALENCE OF RAPID WEIGHT LOSS IN ADOLESCENT TAEKWONDO COMPETITORS B.-E. Berkovich1 , A. Stark1 , A. Eliakim2 , D. Nemet2 , T. Sinai1 . 1 The School of Nutritional Sciences, The Hebrew University of Jerusalem, Rehovot, 2 Child Health and Sports Center, Meir Medical Center, Kfar-Saba, Israel Rationale: Athletes of all ages competing in categorical sports such as taekwondo are divided into weight classes. Before competitions, the desire to reduce weight rapidly leads to extreme measures such as fasting, skipping meals and a variety of dehydration methods. This study examines, for the first time, the prevalence and methods of rapid weight loss (RWL) among Israeli adolescent taekwondo athletes. Methods: Forty-four adolescent (31 males) athletes aged 12 17 were recruited for this study. Each participant completed a validated questionnaire, which was developed to
Poster presentations examine the magnitude and the prevalence of RWL in athletes. Anthropometric measurements were also performed. Results: Average age was 13.46±1.3 years, weight 48.2±10.4 kg, height 158±10.2 cm, BMI 18.99±2.3 kg/m2 . RWL was practiced by 61.4% of the athletes prior to competitions beginning at the average age of 11.7±1.4 yr. Pre-competition weight loss duration was 6±4.9 days, with an average weight reduction of 1.3±1.1 kg. The number of weight loss efforts per athlete in the past season was 2.5±4.3. The majority of the participants increased physical activity (77.7%), skipped meals (54%), and did not practice recommended gradual dieting methods (46.2%). Fasting (at least once) was common (63%). Fifty-seven percent of female athletes and 28% of male athletes indicated that their coaches were the most influential figure in their decision to lose weight prior to competition. Parents were the second most important factor. Conclusion: Prevalence of RWL is high in adolescent taekwondo competitors. The methods used by these athletes are potentially harmful and may lead to significant health risks including compromised nutritional status, diminished physical performance and impaired growth and development. Efforts should be made to promote the awareness of coaches, athletes and parents concerning the potential dangers of RWL in order to limit this phenomenon. Disclosure of Interest: None declared
MON-PP206 ARTIFICIAL NUTRITION: CLINICAL EXPERIENCE AND TREND IN A SOUTHERN ITALY UNIVERSITY HOSPITAL V. Amato1 , C. Pedicini1 , A. De Rosa1 , E. De Rosa1 , C. Del Piano1 , M. Marra1 , L. Santarpia1 , F. Contaldo1 , F. Pasanisi1 , C. De Caprio1 . 1 Clinical Nutrition Unit, Clinical Medicine and Surgery Department, “Federico II” University, Naples, Italy Rationale: To evaluate prevalence of Artificial Nutrition (AN) prescription (Parenteral Nutrition, PN; Enteral Nutrition, EN; Oral Nutritional Supplements, ONS; Mixed Nutrition, MN) in hospitalized patients at “Federico II” University Hospital in Naples, Italy. Methods: One thousand nine hundred twenty-six inpatients on Artificial Nutrition (M = 1063, F = 863; age = 59.3±17.6 years), were evaluated during the years 2004, 2008 and 2012. Paediatric and ICU patients were excluded. Results: Despite an overall decrease in the number of hospitalized patients in the three years survey, (30,506 vs 27,085 vs 23,262), patients on AN were: 506 vs 729 vs 691; 1.66% vs 2.69% vs 2.97%, in particular those receiving EN: 34 vs 53 vs 66; 7.1% vs 7.3% vs 9.6% and ONS: 136 vs 168 vs 179; 28.2% vs 23% vs 26.1% progressively increased. Oncologic inpatients steadily represented the highest percentage of treated patients (1,093; 56.7%), especially in surgical wards (677; 68.3%). An increase of AN treatment in GastroIntestinal (GI) Unit (35 vs 60 vs 73; 6.92% vs 8.23% vs 10.56%) was observed. The overall percentage of diabetic inpatients on AN appears quite high (21.4%). Total days of AN are 19,256 in the three years, with a mean duration of 11±10.8 days (PN 11±10.8; EN 13.1±14.1; ONS 13.1±14.1; MN 11.7±10.1). Despite most of parenteral prescriptions were galenic/personalized (60.0%), a decreasing trend was observed. PN was administered through a short-term central venous catheter (CVC) in 382 (43.7%) patients and peripherally
Obesity and the metabolic syndrome in 385 (44.4%). Complication rate in PN (CVC infections or obstructions) was 0.4%. ONS were prescribed to 25.5% patients. At discharge, 27.6% patients required AN at home (PN 48%, EN 9.5%, ONS 32.6%, MN 9.8%). Conclusion: Hospital AN is increasingly prescribed, mainly as PN with an increasing trend for EN and ONS prescription. About one third of AN inpatients still required treatment at discharge. Disclosure of Interest: None declared
MON-PP207 CLINICAL CHARACTERISTIC AND INDICATIONS TO ARTIFICIAL NUTRITION IN HOSPITALIZAED PATIENTS A THREE YEARS SURVEY V. Amato1 , C. Pedicini1 , A. De Rosa1 , E. De Rosa1 , C. Del Piano1 , L. Santarpia1 , M. Maurizio1 , F. Contaldo1 , F. Pasanisi1 , C. De Caprio1 . 1 Clinical Nutrition Unit, Clinical Medicine and Surgery Department, “Federico II” University, Naples, Italy Rationale: To evaluate characteristics of inpatients on Artificial Nutrition (AN) at “Federico II” University Hospital in Naples, Italy. Methods: One thousand nine hundred twenty-six adult inpatients (1063 M, 863 F; 59.3±17.6 years), followed during the years 2004, 2008 and 2012 were retrospectively evaluated. Results: Of all patients evaluated, 1063 (56.3%) were oncological, 118 (6.2%) neurological, 364 (19.3%) had gastrointestinal (GI) diseases and 344 (18.2%) other diseases. The most frequent oncological diseases involved stomach (197; 18.5%), colon (230; 21.6%) and oral districts (187; 17.6%). As far as neurological patients, main diseases were stroke/vascular (55; 46.5%) and chronic-degenerative (32; 27.1%) diseases; GI diseases were Inflammatory Bowel Diseases (150; 41.2%), Hepatobiliary/Pancreatic (60; 16.5%) diseases and Short Bowel Syndrome/Chronic Intestinal Insufficiency (63; 17.5%). Main indication for AN in oncologic inpatients was proteinenergy malnutrition (53%) due to surgery (456, 44.7%), and nausea/vomiting due to chemotherapy in 181 (17.8%). GI inpatients were on AN for malnutrition (111; 30.7%) and malabsorption (108; 29.8%) whilst neurologic patients needed AN mainly for dysphagia (70; 59.3%). As far as the nutritional treatment, 672 (64.6%) oncological patients were on PN, 96 (9.2%) on EN and 222 (21.3%) received ONS. Thirty-six (30.8%) neurological patients were on PN, 28 (23.9%) on EN and 45 (38.5%) received ONS. Two hundred seventy-four (75.7%) GI patients were on PN and 69 (19.1%) received ONS. At discharge, 325 (27.6%) patients required to continue AN at home; oncological (182; 52%) and GI patients (79; 27.3%) were mostly on PN (41.2% and 29.7%, respectively) whereas neurological patients (14; 4.3%) received ONS (71.4%). Conclusion: Main indication to AN in hospital is malnutrition. About one third patients needed to continue AN at home after discharge. Disclosure of Interest: None declared
S205
Obesity and the metabolic syndrome MON-PP208 MEASURES OF ABDOMINAL OBESITY AND INFLAMMATORY PROFILE IN SUBJECTS WITH PREVIOUS HEART ATTACK A. Marcadenti1,2 , S. Garofallo1 , J. Lorenzon1 , C. Wechenfelder1 , A. Oliveira1 , V. Campos1 , V. Portal1 , on behalf of GENUTRI Study Working Group. 1 Instituto de Cardiologia/Funda¸ca ˜o Universit´ aria de Cardiologia (IC/FUC), 2 Nutri¸ca ˜o, Universidade Federal de Ciˆ encias da Sa´ ude de Porto Alegre (UFCSPA), Porto Alegre, Brazil Rationale: Different abdominal obesity indexes have been proposed instead to waist circumference to detect a worse inflammatory profile in general population. However, they have been poorly tested in patients with cardiovascular disease. Methods: This is a baseline cross-sectional analysis from a randomized clinical trial (GENUTRI Study, NCT02202265) conducted in Southern Brazil. Individuals with previous heart attack and 45 years of age were enrolled. Demographic, clinical and anthropometric data [weight, height in order to calculate body mass index (BMI, kg/m2 ) and waist circumference (WC), in cm] were collected. Plasma C-reactive protein (CRP) and fibrinogen (md/dL) were assessed by ELISA. Lipid Accumulation Product Index (LAP Index, in cm·mmol·l) and Deep-Abdominal Adiposity Tissue Index (DAAT, in cm2 ) were calculated according to gender. Nonparametric data were log-transformed and Pearson correlation and multiple linear regression were used for statistical analyses. Results: In total, 64 patients (73.4% men) were evaluated with a mean age 56.2±16.0 years, 51.6% current or ex-smokers and 39.1% with obesity according to BMI 30 kg/m2 . Regarding to clinical conditions, 50% had hypertension, 25% had type-2 diabetes mellitus and 53.1% had dyslipidemia. In men, CRP was significantly correlated with LAP (r = 0.30, P = 0.04), DAAT (r = 0.39, P = 0.007) and WC (r = 0.44, P = 0.002) and fibrinogen with DAAT (r = 0.34, P = 0.02) and WC (r = 0.35, P = 0.02); in women, CRP was significantly correlated with DAAT (r = 0.56, P = 0.02) and WC (r = 0.57, P = 0.02) and fibrinogen with LAP (r = 0.49, P = 0.04), DAAT (r = 0.63, P = 0.006) and WC (r = 0.59, P = 0.01). However, when adjusted for age and BMI, none of these abdominal obesity indexes were associated with the inflammatory profile in both genders. Conclusion: Overall obesity seems to strongly influence the levels of inflammatory markers in a sample of patients with previous heart attack. Disclosure of Interest: None declared
MON-PP205 HIGH PREVALENCE OF RAPID WEIGHT LOSS IN ADOLESCENT TAEKWONDO COMPETITORS B.-E. Berkovich1 , A. Stark1 , A. Eliakim2 , D. Nemet2 , T. Sinai1 . 1 The School of Nutritional Sciences, The Hebrew University of Jerusalem, Rehovot, 2 Child Health and Sports Center, Meir Medical Center, Kfar-Saba, Israel Rationale: Athletes of all ages competing in categorical sports such as taekwondo are divided into weight classes. Before competitions, the desire to reduce weight rapidly leads to extreme measures such as fasting, skipping meals and a variety of dehydration methods. This study examines, for the first time, the prevalence and methods of rapid weight loss (RWL) among Israeli adolescent taekwondo athletes. Methods: Forty-four adolescent (31 males) athletes aged 12 17 were recruited for this study. Each participant completed a validated questionnaire, which was developed to
Poster presentations examine the magnitude and the prevalence of RWL in athletes. Anthropometric measurements were also performed. Results: Average age was 13.46±1.3 years, weight 48.2±10.4 kg, height 158±10.2 cm, BMI 18.99±2.3 kg/m2 . RWL was practiced by 61.4% of the athletes prior to competitions beginning at the average age of 11.7±1.4 yr. Pre-competition weight loss duration was 6±4.9 days, with an average weight reduction of 1.3±1.1 kg. The number of weight loss efforts per athlete in the past season was 2.5±4.3. The majority of the participants increased physical activity (77.7%), skipped meals (54%), and did not practice recommended gradual dieting methods (46.2%). Fasting (at least once) was common (63%). Fifty-seven percent of female athletes and 28% of male athletes indicated that their coaches were the most influential figure in their decision to lose weight prior to competition. Parents were the second most important factor. Conclusion: Prevalence of RWL is high in adolescent taekwondo competitors. The methods used by these athletes are potentially harmful and may lead to significant health risks including compromised nutritional status, diminished physical performance and impaired growth and development. Efforts should be made to promote the awareness of coaches, athletes and parents concerning the potential dangers of RWL in order to limit this phenomenon. Disclosure of Interest: None declared
MON-PP206 ARTIFICIAL NUTRITION: CLINICAL EXPERIENCE AND TREND IN A SOUTHERN ITALY UNIVERSITY HOSPITAL V. Amato1 , C. Pedicini1 , A. De Rosa1 , E. De Rosa1 , C. Del Piano1 , M. Marra1 , L. Santarpia1 , F. Contaldo1 , F. Pasanisi1 , C. De Caprio1 . 1 Clinical Nutrition Unit, Clinical Medicine and Surgery Department, “Federico II” University, Naples, Italy Rationale: To evaluate prevalence of Artificial Nutrition (AN) prescription (Parenteral Nutrition, PN; Enteral Nutrition, EN; Oral Nutritional Supplements, ONS; Mixed Nutrition, MN) in hospitalized patients at “Federico II” University Hospital in Naples, Italy. Methods: One thousand nine hundred twenty-six inpatients on Artificial Nutrition (M = 1063, F = 863; age = 59.3±17.6 years), were evaluated during the years 2004, 2008 and 2012. Paediatric and ICU patients were excluded. Results: Despite an overall decrease in the number of hospitalized patients in the three years survey, (30,506 vs 27,085 vs 23,262), patients on AN were: 506 vs 729 vs 691; 1.66% vs 2.69% vs 2.97%, in particular those receiving EN: 34 vs 53 vs 66; 7.1% vs 7.3% vs 9.6% and ONS: 136 vs 168 vs 179; 28.2% vs 23% vs 26.1% progressively increased. Oncologic inpatients steadily represented the highest percentage of treated patients (1,093; 56.7%), especially in surgical wards (677; 68.3%). An increase of AN treatment in GastroIntestinal (GI) Unit (35 vs 60 vs 73; 6.92% vs 8.23% vs 10.56%) was observed. The overall percentage of diabetic inpatients on AN appears quite high (21.4%). Total days of AN are 19,256 in the three years, with a mean duration of 11±10.8 days (PN 11±10.8; EN 13.1±14.1; ONS 13.1±14.1; MN 11.7±10.1). Despite most of parenteral prescriptions were galenic/personalized (60.0%), a decreasing trend was observed. PN was administered through a short-term central venous catheter (CVC) in 382 (43.7%) patients and peripherally
Obesity and the metabolic syndrome in 385 (44.4%). Complication rate in PN (CVC infections or obstructions) was 0.4%. ONS were prescribed to 25.5% patients. At discharge, 27.6% patients required AN at home (PN 48%, EN 9.5%, ONS 32.6%, MN 9.8%). Conclusion: Hospital AN is increasingly prescribed, mainly as PN with an increasing trend for EN and ONS prescription. About one third of AN inpatients still required treatment at discharge. Disclosure of Interest: None declared
MON-PP207 CLINICAL CHARACTERISTIC AND INDICATIONS TO ARTIFICIAL NUTRITION IN HOSPITALIZAED PATIENTS A THREE YEARS SURVEY V. Amato1 , C. Pedicini1 , A. De Rosa1 , E. De Rosa1 , C. Del Piano1 , L. Santarpia1 , M. Maurizio1 , F. Contaldo1 , F. Pasanisi1 , C. De Caprio1 . 1 Clinical Nutrition Unit, Clinical Medicine and Surgery Department, “Federico II” University, Naples, Italy Rationale: To evaluate characteristics of inpatients on Artificial Nutrition (AN) at “Federico II” University Hospital in Naples, Italy. Methods: One thousand nine hundred twenty-six adult inpatients (1063 M, 863 F; 59.3±17.6 years), followed during the years 2004, 2008 and 2012 were retrospectively evaluated. Results: Of all patients evaluated, 1063 (56.3%) were oncological, 118 (6.2%) neurological, 364 (19.3%) had gastrointestinal (GI) diseases and 344 (18.2%) other diseases. The most frequent oncological diseases involved stomach (197; 18.5%), colon (230; 21.6%) and oral districts (187; 17.6%). As far as neurological patients, main diseases were stroke/vascular (55; 46.5%) and chronic-degenerative (32; 27.1%) diseases; GI diseases were Inflammatory Bowel Diseases (150; 41.2%), Hepatobiliary/Pancreatic (60; 16.5%) diseases and Short Bowel Syndrome/Chronic Intestinal Insufficiency (63; 17.5%). Main indication for AN in oncologic inpatients was proteinenergy malnutrition (53%) due to surgery (456, 44.7%), and nausea/vomiting due to chemotherapy in 181 (17.8%). GI inpatients were on AN for malnutrition (111; 30.7%) and malabsorption (108; 29.8%) whilst neurologic patients needed AN mainly for dysphagia (70; 59.3%). As far as the nutritional treatment, 672 (64.6%) oncological patients were on PN, 96 (9.2%) on EN and 222 (21.3%) received ONS. Thirty-six (30.8%) neurological patients were on PN, 28 (23.9%) on EN and 45 (38.5%) received ONS. Two hundred seventy-four (75.7%) GI patients were on PN and 69 (19.1%) received ONS. At discharge, 325 (27.6%) patients required to continue AN at home; oncological (182; 52%) and GI patients (79; 27.3%) were mostly on PN (41.2% and 29.7%, respectively) whereas neurological patients (14; 4.3%) received ONS (71.4%). Conclusion: Main indication to AN in hospital is malnutrition. About one third patients needed to continue AN at home after discharge. Disclosure of Interest: None declared
S205
Obesity and the metabolic syndrome MON-PP208 MEASURES OF ABDOMINAL OBESITY AND INFLAMMATORY PROFILE IN SUBJECTS WITH PREVIOUS HEART ATTACK A. Marcadenti1,2 , S. Garofallo1 , J. Lorenzon1 , C. Wechenfelder1 , A. Oliveira1 , V. Campos1 , V. Portal1 , on behalf of GENUTRI Study Working Group. 1 Instituto de Cardiologia/Funda¸ca ˜o Universit´ aria de Cardiologia (IC/FUC), 2 Nutri¸ca ˜o, Universidade Federal de Ciˆ encias da Sa´ ude de Porto Alegre (UFCSPA), Porto Alegre, Brazil Rationale: Different abdominal obesity indexes have been proposed instead to waist circumference to detect a worse inflammatory profile in general population. However, they have been poorly tested in patients with cardiovascular disease. Methods: This is a baseline cross-sectional analysis from a randomized clinical trial (GENUTRI Study, NCT02202265) conducted in Southern Brazil. Individuals with previous heart attack and 45 years of age were enrolled. Demographic, clinical and anthropometric data [weight, height in order to calculate body mass index (BMI, kg/m2 ) and waist circumference (WC), in cm] were collected. Plasma C-reactive protein (CRP) and fibrinogen (md/dL) were assessed by ELISA. Lipid Accumulation Product Index (LAP Index, in cm·mmol·l) and Deep-Abdominal Adiposity Tissue Index (DAAT, in cm2 ) were calculated according to gender. Nonparametric data were log-transformed and Pearson correlation and multiple linear regression were used for statistical analyses. Results: In total, 64 patients (73.4% men) were evaluated with a mean age 56.2±16.0 years, 51.6% current or ex-smokers and 39.1% with obesity according to BMI 30 kg/m2 . Regarding to clinical conditions, 50% had hypertension, 25% had type-2 diabetes mellitus and 53.1% had dyslipidemia. In men, CRP was significantly correlated with LAP (r = 0.30, P = 0.04), DAAT (r = 0.39, P = 0.007) and WC (r = 0.44, P = 0.002) and fibrinogen with DAAT (r = 0.34, P = 0.02) and WC (r = 0.35, P = 0.02); in women, CRP was significantly correlated with DAAT (r = 0.56, P = 0.02) and WC (r = 0.57, P = 0.02) and fibrinogen with LAP (r = 0.49, P = 0.04), DAAT (r = 0.63, P = 0.006) and WC (r = 0.59, P = 0.01). However, when adjusted for age and BMI, none of these abdominal obesity indexes were associated with the inflammatory profile in both genders. Conclusion: Overall obesity seems to strongly influence the levels of inflammatory markers in a sample of patients with previous heart attack. Disclosure of Interest: None declared